Pediatrics Commons^™

Neuropsychiatric Effects Of Tenofovir In Comparison With Other Antiretroviral Drugs., Kathleen Ferrer, Natella Rakhmanina

Pediatrics Faculty Publications

Tenofovir is a widely used antiretroviral medication indicated to treat adults and children infected with HIV. Current guidelines for the management of HIV infection recommend tenofovir disoproxil fumarate (TDF) as a component of the preferred first-line combination antiretroviral therapy. The efficacy, tolerability, prolonged half-life allowing for once-daily administration, and availability as a component of several fixed-dose formulations make TDF an attractive choice for treatment-naive and treatment-experienced HIV-infected patients. TDF is also widely used as a component of postexposure prophylaxis in noninfected individuals. Most importantly, it has been recently approved for use as pre-exposure prophylaxis for noninfected adults and adolescents to …

Wound Care Challenges In Children And Adults With Spina Bifida: An Open-Cohort Study, Katherine Ottolini, Amy B. Harris, June K. Amling, Ann M. Kennelly, Leslie A. Phillips, Laura L. Tosi

Pediatrics Faculty Publications

Skin breakdown is a frequent concern for individuals with spina bifida. We explored wound incidence in patients with spina bifida and how it varies across a person's life span and functional neurologic level. We examined the settings in which skin breakdown most commonly occurred, looking for evidence of chronic, non-healing wounds. We also sought to develop criteria to improve wound monitoring. We identified reported wound episodes in an open-cohort study over a 13-year period, examining the hospital and outpatient clinical records of spina bifida patients at Children's National Medical Center (CNMC). Current age, age at wound presentation, sex, weight, functional …

The Association Of Cd81 Polymorphisms With Alloimmunization In Sickle Cell Disease, Zohreh Tatari-Calderone, Ryad Tamouza, Gama P. Lebouder, Ramita Dewan, Naomi L. Luban, Jacqueline Lasserre, Jacqueline Maury, Francois Lionnet, Rajagopal Krishnamoorthy, Robert Girot, Stanislav Vukmanovic

Pediatrics Faculty Publications

The goal of the present work was to identify the candidate genetic markers predictive of alloimmunization in sickle cell disease (SCD). Red blood cell (RBC) transfusion is indicated for acute treatment, prevention, and abrogation of some complications of SCD. A well-known consequence of multiple RBC transfusions is alloimmunization. Given that a subset of SCD patients develop multiple RBC allo-/autoantibodies, while others do not in a similar multiple transfusional setting, we investigated a possible genetic basis for alloimmunization. Biomarker(s) which predicts (predict) susceptibility to alloimmunization could identify patients at risk before the onset of a transfusion program and thus may have …

Activation Of Human Herpesvirus Replication By Apoptosis, Alka Prasad, Jil Remick, Steven L. Zeichner

Pediatrics Faculty Publications

A central feature of herpesvirus biology is the ability of herpesviruses to remain latent within host cells. Classically, exposure to inducing agents, like activating cytokines or phorbol esters that stimulate host cell signal transduction events, and epigenetic agents (e.g., butyrate) was thought to end latency. We recently showed that Kaposi's sarcoma-associated herpesvirus (KSHV, or human herpesvirus-8 [HHV-8]) has another, alternative emergency escape replication pathway that is triggered when KSHV's host cell undergoes apoptosis, characterized by the lack of a requirement for the replication and transcription activator (RTA) protein, accelerated late gene kinetics, and production of virus with decreased infectivity. Caspase-3 …

Oximetry Signal Processing Identifies Rem Sleep-Related Vulnerability Trait In Asthmatic Children, Geovanny F. Perez, Maria J. Gutierrez, Shehlanoor Huseni, Krishna Pancham, Carlos E. Rodriguez-Martinez, Cesar L. Nino, Gustavo Nino

Pediatrics Faculty Publications

Rationale. The sleep-related factors that modulate the nocturnal worsening of asthma in children are poorly understood. This study addressed the hypothesis that asthmatic children have a REM sleep-related vulnerability trait that is independent of OSA.

Methods. We conducted a retrospective cross-sectional analysis of pulse-oximetry signals obtained during REM and NREM sleep in control and asthmatic children (n=134). Asthma classification was based on preestablished clinical criteria. Multivariate linear regression model was built to control for potential confounders (significance level p ≤ 0.05).

Results. Our data demonstrated that (1) baseline nocturnal respiratory parameters were not significantly different in asthmatic versus control children, …

Low Plasma Citrulline Levels Are Associated With Acute Respiratory Distress Syndrome In Patients With Severe Sepsis, Lorraine B. Ware, Jordan A. Magarik, Nancy Wickersham, Gary Cunningham, Todd W. Rice, Brian W. Christman, Arthur P. Wheeler, Gordon R. Bernard, Marshall Summar

Pediatrics Faculty Publications

Introduction: The role of nitric oxide synthase (NOS) in the pathophysiology of acute respiratory distress syndrome (ARDS) is not well understood. Inducible NOS is upregulated during physiologic stress; however, if NOS substrate is insufficient then NOS can uncouple and switch from NO generation to production of damaging peroxynitrites. We hypothesized that NOS substrate levels are low in patients with severe sepsis and that low levels of the NOS substrate citrulline would be associated with end organ damage including ARDS in severe sepsis.

Methods: Plasma citrulline, arginine and ornithine levels and nitrate/nitrite were measured at baseline in 135 patients with severe …

Can Coronary Artery Involvement In Kawasaki Disease Be Predicted?, Sunil J. Ghelani, Neha Kwatra, Christopher F. Spurney

Pediatrics Faculty Publications

Background: Coronary artery involvement is seen in approximately 15–20% of children with Kawasaki disease. There is conflicting literature regarding the clinical and laboratory findings associated with coronary artery involvement. In this retrospective study, we attempt identification of predictive factors for coronary artery involvement at our institute and review the existing literature.

Methods and results: A review of 203 patients (65% males) with Kawasaki disease was performed, of whom 33 (16.3%) had coronary artery involvement. High erythrocyte sedimentation rate, high platelet count, low hematocrit, low albumin levels, and refractory Kawasaki disease showed significant association with coronary artery involvement. High …

Alloreactivity-Based Medical Conditions, Stanislav Vukmanovic, Margaret G. Petroff, Anne M. Stevens, Daniel Rukavina

Pediatrics Faculty Publications

No abstract provided.

The Impact Of The Internet On The Sexual Health Of Adolescents: A Brief Review, Julia Springate, Hatim A. Omar

Pediatrics Faculty Publications

The object of this review is to summarize the impact of the Internet on the sexual health of adolescents. This article examines the use of websites, blogs and chat rooms as sources for sexual health information for adolescents. The influence of Internet pornography on sexual behaviors and attitudes is addressed. The use of the Internet as a place to find sexual partners is also assessed. During a time of great physical, emotional and sexual change, the Internet is playing a huge role in the decisions adolescents are making, both positive and negative.

Neuromyelitis Optica In Child: Diagnostic And Therapeutic Challenges, Karolina Dembinski, Maria Gieron-Korthals, Carlos R. Martinez, Lisa Rodriguez

Pediatrics Faculty Publications

Neuromyelitis optica (NMO) is a rare syndrome of severe inflammatory demyelination of the central nervous system, causing attacks of optic neuritis and transverse myelitis. Although uncommon, attention should be given to the proper identification and management of the affected patients. We present a case of a 13-year-old girl with severe neuromyelitis optica. The patient’s initial presentation consisted of encephalopathy and optic neuritis. Approximately 2 months later, coinciding with the weaning of steroid treatment, she presented with ascending paralysis and respiratory failure. She was seropositive for NMO-IgG. Treatment included intravenous immune globulin, steroids, plasmapheresis, and rituximab and was complemented with proper …

Plac1 Expression Decreases In Chorionic Villi In Response To Labor, Yahdira M. Rodriguez-Prado, Xiaoyuan Kong, Michael E. Fant

Pediatrics Faculty Publications

PLAC1 (Placenta-Specific 1) is a recently described, trophoblast-expressed gene essential for normal placental development. The protein localizes to the microvillus membrane surface of the syncytiotrophoblast in direct proximity to the maternal compartment. Although its role has not been defined, increased circulating levels of human PLAC1 mRNA in maternal blood are associated with preeclampsia. Furthermore, PLAC1-null mice exhibit decreased viability in the peripartum period suggesting a role in pregnancy maintenance late in gestation. We examined PLAC1 gene expression in the human placenta during normal pregnancy and pregnancies associated with maternal diabetes and preeclampsia using quantitative, real time PCR (q-RT-PCR). Although …

Complex Cytogenetic Rearrangements At The Durs1 Locus In Syndromic Duane Retraction Syndrome, Hagit N. Baris, Wai-Man Chan, Caroline Andrews, Doron M. Behar, Diana J. Donovan, Cynthia C. Morton, Judith Ranells, Tuya Pal, Azra H. Ligon, Elizabeth C. Engle

Pediatrics Faculty Publications

No abstract provided.

A New Millennium: A New Age Of Behavioral Disorders?, Artemis Tsitsika, Mari Janikian, Donald E. Greydanus, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

The internet has become one of the most widely accessible media and is a significant part of everyday life in adolescence, offering opportunities for social networking and communication, education and entertainment. However, over the past decade a specific behavioral pattern has been researched in respect to Internet use, leading to isolation and neglect of everyday activities, social life –even personal health in general. The phenomenon has received increasing attention from the scientific community, describing it in various terms such as “excessive”, “problematic”, “pathological”, “addictive” use among others.

European research on Internet addictive behavior have been conducted in the past years …

Internet Addiction, Media Use, And Difficulties Associated With Sleeping In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this review article is to summarize the current literature regarding Internet addiction; media use, and sleep disruption in adolescents. Design: Systematic review of current literature. Methods: The data was obtained through literature review of articles published in the last 10 years. Conclusion: Internet addiction and media use have the power to have great influence over the sleep of children and adolescents and it is important to take advantage of the positive effects of media while minimizing the potentially negative, but severe, consequence of sleep disruption.

Cyberbullying: A Brief Review, Amy L. Burnett, John A. Yozwiak, Hatim A. Omar

Pediatrics Faculty Publications

The objective of this review is to summarize the prevalence of Internet use among the adolescent population and the growing threat of cyberbullying. This manuscript also addresses the difference between cyberbullying and traditional bullying and the negative psychological effects that result from cyberbullying. Important intervention and prevention strategies for parents and school officials are noted as well.

Genomic Loss Of Tumor Suppressor Mirna-204 Promotes Cancer Cell Migration And Invasion By Activating Akt/Mtor/Rac1 Signaling And Actin Reorganization, Saadi J. Imam, Jason R. Plyler, Hima Bansal, Suresh Prajapati, Sanjay Bansal, Jennifer Rebeles, Jeffrey S. Dome, +12 Additional Authors

Pediatrics Faculty Publications

Increasing evidence suggests that chromosomal regions containing microRNAs are functionally important in cancers. Here, we show that genomic loci encoding miR-204 are frequently lost in multiple cancers, including ovarian cancers, pediatric renal tumors, and breast cancers. MiR-204 shows drastically reduced expression in several cancers and acts as a potent tumor suppressor, inhibiting tumor metastasis in vivo when systemically delivered. We demonstrated that miR-204 exerts its function by targeting genes involved in tumorigenesis including brain-derived neurotrophic factor (BDNF), a neurotrophin family member which is known to promote tumor angiogenesis and invasiveness. Analysis of primary tumors shows that increased expression …

The Involvement Of Acidic Nucleoplasmic Dna-Binding Protein (And-1) In The Regulation Of Prereplicative Complex (Pre-Rc) Assembly In Human Cells, Yongming Li, Haijie Xiao, Christelle De Renty, Aimee Jaramillo-Lambert, Zhiyong Han, Melvin L. Depamphilis, Kristy J. Brown, Wenge Zhu

Pediatrics Faculty Publications

No abstract provided.

Post-Transfusion Purpura In An African-American Man Due To Human Platelet Antigen-5b Alloantibody: A Case Report, Filipa Lynce, Fang Yin, Kirsten Alcorn, Vera Malkovska

Pediatrics Faculty Publications

Introduction

Post-transfusion purpura is a rare immunohematological disorder characterized by severe thrombocytopenia following transfusion of blood components and induced by an alloantibody against a donor platelet antigen. It occurs primarily in women sensitized by pregnancy and is most commonly caused by anti-human platelet antigen-1a antibodies. Here, we describe what we believe to be the first documented case of an African-American man who developed post-transfusion purpura due to an anti-human platelet antigen-5b alloantibody after receiving multiple blood products.

Case presentation

A 68-year-old African-American man initially admitted with atrial flutter was started on anticoagulation treatment, which was complicated by severe hematemesis. On …

Prevalence Of Obesity Among Young Asian-American Children, Anjali Jain, Stephanie Mitchell, Radha Chirumamilla, Jin Zhang, Ivor B. Horn, Amy Lewin, Z. Jennifer Huang

Pediatrics Faculty Publications

BACKGROUND:

Asian-American children are considered to be at low risk of obesity, but previous estimates have not distinguished between children from different Asian countries. We estimate the prevalence of obesity among Asian-American children by mother's country of origin, generational status, and family socioeconomic factors using a secondary analysis of the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) wave III (children ∼4 years old) dataset.

METHODS:

The ECLS-B is a nationally representative study of children born in 2001 that oversampled births to Asian mothers. Asian ethnic categories included Chinese, Japanese, Filipino, Asian Indian, Korean, Vietnamese, and Other Asian/Pacific Islander. The primary outcome …

Twice-Daily Application Of Hiv Microbicides Alters The Vaginal Microbiota, Jacques Ravel, Pawel Gajer, Li Fu, Christine K. Mauck, Sara S.K. Koenig, Joyce Sakamoto, Alison A. Motsinger-Reif, Gustavo F. Doncel, Steven L. Zeichner

Pediatrics Faculty Publications

Vaginal HIV microbicides offer great promise in preventing HIV transmission, but failures of phase 3 clinical trials, in which microbicide-treated subjects had an increased risk of HIV transmission, raised concerns about endpoints used to evaluate microbicide safety. A possible explanation for the increased transmission risk is that the agents shifted the vaginal bacterial community, resulting in loss of natural protection and enhanced HIV transmission susceptibility. We characterized vaginal microbiota, using pyrosequencing of bar-coded 16S rRNA gene fragments, in samples from 35 healthy, sexually abstinent female volunteer subjects (ages 18 to 50 years) with regular menses in a repeat phase 1 …

Gender Differences In The Developmental Outcomes Of Children With Congenital Cardiac Defects, Annette Majnemer, Catherine Limperopoulos, Michael Shevell, Charles Rohlicek, Bernard Rosenblatt, Chirsto Tchervenkov

Pediatrics Faculty Publications

Objective: This study compares the developmental and functional outcomes at school entry between boys and girls born with a congenital cardiac defect who required early surgical correction.

Study design: A prospective cohort of 94 children, including 49 percent boys, were followed up to 5 years of age and assessed for developmental progress. Developmental measures included Wechsler Preschool and Primary Scale of Intelligence – cognitive; Peabody Picture Vocabulary Test – receptive language; Peabody Developmental Motor Scale – motor; and Child Behaviour Checklist – behaviour. Measures of function included the Vineland Adaptive Behavior Scale and Functional Independence Measure for Children (WeeFIM).

Results: …

Infliximab Dose Rounding Pratices In Pediatric Inflammatory Bowel Disease, Kelly C. Sandberg, Benjamin H. Shpeen, Sally J. Eder, Muhammad Dhanani, Sarah J. Clark, Gary L. Freed, Jeremy Adler

Pediatrics Faculty Publications

Infliximab (IFX) is commonly used to treat Inflammatory Bowel Disease (IBD). IFX is supplied in 100mg vials and remains expensive. Dosing usually starts at 5mg/kg, and is commonly rounded up or down. The scope of dosing practices is unknown. Under-dosing may place patients at risk for exacerbation of IBD. Over-treatment potentially carries increased risk of infectious and malignant complications. We aimed to characterize IFX dosing practices among pediatric IBD practitioners participating in the ImproveCareNow Network.

Development Of Chinese Adolescents: Assessment, Issues, And Intervention, Daniel T. L. Shek, Rachel C. F. Sun, Joav Merrick

Pediatrics Faculty Publications

No abstract.

Feasibility Of Implementing Pulse Oximetry Screening For Congenital Heart Disease In A Community Hospital., Elizabeth A. Bradshaw, Sandra Cuzzi, S. C. Kiernan, N. Nagel, Jeffrey A. Becker, Gerard R. Martin

Pediatrics Faculty Publications

Objective:

Pulse oximetry has been recognized as a promising screening tool for critical congenital heart disease (CCHD). The aim of this research was to study the feasibility of implementation in a community hospital setting.

Study Design:

Meetings were conducted to determine an implementation plan. Pulse oximetry was performed on the right hand and foot after 24h of age. Newborns with a saturation 95% or a 3% difference were considered to have a positive screen. Screening barriers, screening time and ability to effectively screen all eligible newborns were noted.

Result:

From January 2009 through May 2010, of 6841 eligible newborns, 6745 …

Use Of Quantitative Membrane Proteomics Identifies A Novel Role Of Mitochondria In Healing Injured Muscles., Nimisha Sharma, Sushma Medikayala, Sree Rayavarapu, Kristy J. Brown, Yetrib Hathout, Jyoti K. Jaiswal, Aurelia Defour

Pediatrics Faculty Publications

Skeletal muscles are proficient at healing from a variety of injuries. Healing occurs in two phases, early and late phase. Early phase involves healing the injured sarcolemma and restricting the spread of damage to the injured myofiber. Late phase of healing occurs a few days postinjury and involves interaction of injured myofibers with regenerative and inflammatory cells. Of the two phases, cellular and molecular processes involved in the early phase of healing are poorly understood. We have implemented an improved sarcolemmal proteomics approach together with in vivo labeling of proteins with modified amino acids in mice to study acute changes …

Reflective Journals Of Students Taking A Positive Youth-Development Course In A University Context In Hong Kong, Daniel T. L. Shek, Florence K. Y. Wu

Pediatrics Faculty Publications

To promote the holistic development of university students, a course entitled "Tomorrow's Leaders" was developed and offered at The Hong Kong Polytechnic University. Based on a case study approach, reflective journals of five outstanding students of the course are presented and analyzed (i.e., thick description), with several themes emerging from the reflection. First, the students liked the course, and they identified many positive attributes. Second, the students appreciated the instructors. Third, the students viewed that the course contributed to different aspects of their development. Fourth, some areas of improvements were proposed. In conjunction with other evaluation mechanisms, the present findings …

Subjective Outcome Evaluation Of The Project P.A.T.H.S. (Extension Phase) Based On The Perspective Of Program Implementer, Daniel T. L. Shek, Lu Yu

Pediatrics Faculty Publications

A total of 231 schools participated in the Project P.A.T.H.S. in 2009/2010 school year. After completion of the Tier 1 Program, subjective outcome evaluation data were collected from 3,259 program implementers. Based on the consolidated data with schools as units, results showed that participants had positive perceptions of the program, implementers, and benefits of the program. More than four-fifth of the implementers regarded the program as helpful to the program participants. Multiple regression analyses revealed that perceived qualities of the program and the program implementers predicted perceived effectiveness of the program. Similar to previous studies, compared to implementers' perception about …

Parent-Clinician Communication Intervention During End-Of-Life Decision Making For Children With Incurable Cancer., Pamela S. Hinds, Linda L. Oakes, Judy Hicks, Brent Powell, Deo K. Srivastava, Justin N. Baker, Sheri L. Spunt, Nancy K. West, Wayne L. Furman

Pediatrics Faculty Publications

Background: In this single-site study, we evaluated the feasibility of a parent-clinician communication intervention designed to: identify parents' rationale for the phase I, do-not-resuscitate (DNR), or terminal care decision made on behalf of their child with incurable cancer; identify their definition of being a good parent to their ill child; and provide this information to the child's clinicians in time to be of use in the family's care.

Methods: Sixty-two parents of 58 children and 126 clinicians participated. Within 72 hours after the treatment decision, parents responded to 6 open-ended interview questions and completed a 10-item questionnaire about the end-of-life …

Family And Personal Adjustment Of Economically Disadvantaged Chinese Adolescents In Hong Kong, Daniel T. L. Shek, Pik Fong Tsui

Pediatrics Faculty Publications

This study attempted to examine the relationship between poverty and adolescent developmental outcomes in the family and personal domains in 3,328 Chinese secondary school students in Hong Kong. Developmental outcomes included positive youth development constructs, problem behaviors, perceived family interaction, and parental parenting. Results showed that adolescents experiencing poverty did not differ from nonpoor adolescents in terms of risk behavior and in most indicators of positive youth development. On the other hand, adolescents with economic disadvantage displayed lower levels of positive identity, family interaction, and perceived paternal parenting than did those without economic disadvantage.

Subjective Outcome Evaluation Of The Project P.A.T.H.S. In Different Cohorts Of Students, Daniel T. L. Shek, Cecilia M. S. Ma

Pediatrics Faculty Publications

The project P.A.T.H.S. is an indigenously developed positive youth development program in Hong Kong. In the extension phase (2009/2010 school year), subjective outcome evaluation data were collected from 231 schools involving 89,068 participants after completion of the curricula-based Tier 1 Program. With schools as the units of analysis, results showed that participants generally had positive perceptions of the program content and implementers, with over four-fifth of the participants regarded the program as helpful to them. There were some significant grade differences in the subjective outcome evaluation findings, although the related effect size was not strong. Multiple regression analyses revealed that …